The assessment by the Centers for Medicare & Medicaid Services (CMS) of financial penalties against hospitals with excessive readmission rates has been controversial from the outset. CMS does not adjust data for complexity of illness or low socioeconomic status and thus unfairly penalizes hospitals that care for these types of patients: typically academic medical centers and safety net hospitals.1 Even though the various controversies about this program remain unresolved, CMS has expanded it from 3 medical conditions to include all readmissions.